Grody W W, Jobst S, Keesey J, Herrmann C, Naeim F
Arch Pathol Lab Med. 1986 Sep;110(9):843-6.
Eleven thymectomy specimens from patients with myasthenia gravis or Lambert-Eaton myasthenic syndrome were thoroughly sectioned. The results were compared with the routine surgical pathology reports that were based on a median of four sections. Routine sampling was found to be inadequate because the thymectomy specimens were inhomogeneous--some random sections contained germinal centers while others did not. Thus, on more thorough examination, about half of the specimens should have been diagnosed as showing "follicular hyperplasia" rather than "no diagnostic change" or "involution." This helps explain the conflicting results of previous studies, based when stated on a mean of three sections, in which favorable response to thymectomy in patients with myasthenia gravis was either not correlated with the thymus histologic state or correlated variously with few or numerous germinal centers. Thus, nondiagnostic histologic findings based on only one or two thymus sections should be suspect, and if in doubt a larger number of sections should be examined for accurate pathologic diagnosis.
对11例重症肌无力或兰伯特-伊顿肌无力综合征患者的胸腺切除标本进行了全面切片。将结果与基于平均四个切片的常规手术病理报告进行了比较。发现常规采样不充分，因为胸腺切除标本不均匀——一些随机切片含有生发中心，而另一些则没有。因此，经过更全面的检查，大约一半的标本应被诊断为显示“滤泡增生”，而不是“无诊断性改变”或“退化”。这有助于解释先前研究的矛盾结果，这些研究在平均三个切片的基础上进行陈述，其中重症肌无力患者对胸腺切除术的良好反应要么与胸腺组织学状态无关，要么与少数或众多生发中心有不同程度的关联。因此，仅基于一两个胸腺切片的非诊断性组织学结果应受到怀疑，如有疑问，应检查更多切片以进行准确的病理诊断。
